Program

Hitkashrut

The
Hitkashrut parent training program is designed to reshape parent-child
interactions to reduce conduct problems in at-risk preschoolers. This culturally
adaptive program was found to have positive impacts on child behavior problems,
callous/unemotional traits, and effortful control compared with a control group
that received minimal intervention. Positive impacts were also found for
parental distress, inconsistent/negative parenting, and marital quality.

DESCRIPTION OF PROGRAM

Target Population:
Preschoolers at risk for conduct problems and their parents.

Hitkashrut, which means “attachment” in Hebrew, is a theory-based, “common
elements” parent training program that targets families with children who are
showing early signs of conduct problem development. Using a family systems
approach, this program aims to motivate children to shift from antisocial to
prosocial attitudes by reshaping the parent-child relationship. This program
targets callous/unemotional traits and low effortful control, which are
indicators of a developmental trajectory toward antisocial or disruptive
behaviors. The program involves 14 group sessions facilitated by psychologists
that include psycho-educational instruction, group discussions, role plays, and
homework assignments. The program’s six components are: (1) Interaction
quality/time, (2) Parent-child communication skills, (3) Behavior management,
(4) Discipline skills, (5) Parent self-regulation capacity, and (6) Couple
communication skills.

Hitkashrut
uses a collaborative model in which both caregivers and teachers are involved in
effective behavior management. This program was designed to be cost-efficient
for use with diverse communities in the real-world. While it is manual-based,
it attempts to maximize flexibility and cultural adaptability.

Evaluated
Population:
The sample
consisted of 209 families with a pre-school aged child who was identified as at
risk for conduct problems (CP). Inclusion in the study was based on the child’s
age (3-5 years old), the presence of significant behavioral problems as reported
by a teacher, no physical or intellectual disabilities, no other psychological
treatment, and agreement of both caregivers to participate. The children in the
sample were 78 percent male with an average age of 49 months (4 years, 1
month). The race/ethnicity of the sample was not reported.

Approach: This
sample was recruited from pre-kindergarten classes by the Ministry of Education
in Jerusalem. Families were randomized to receive the Hitkashrut intervention
(n = 140) or to a minimal treatment control condition (n = 69). No significant
differences existed between the groups at baseline. The Hitkashrut intervention
involved 14 2-hour culturally-adapted sessions facilitated by psychologists with
groups of 5 to 7 couples, while the minimal treatment condition involved two
consultation sessions with facilitators, handouts, and referrals if necessary.

Parent-reported behavior problems, effortful control (behavior regulation),
callous/unemotional traits, parent distress, negative/inconsistent parenting,
and marital quality were measured pre-intervention, one month post-intervention,
and at a one year follow-up. Low effortful control and high callous/unemotional
traits are associated with disruptive and antisocial behaviors. Eighty-seven
percent of families completed the assessment at post-intervention, while 60
percent completed the assessment at follow-up. Due to the attrition rate,
intent to treat analyses were not done with the one year follow-up data; results
for the one year follow-up are therefore not reported here.